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Swallowing outcomes after pediatric epiglottopexy

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Abstract

Introduction

Persistent sleep apnea following tonsillectomy and adenoidectomy in children requires additional evaluation. One of the common areas of persistent upper airway obstruction in these children is the base of the tongue and lingual tonsils as well as epiglottic prolapse. Depending on the site of obstruction on sleep endoscopy or a cine MRI, surgical procedures include base of tongue reduction and lingual tonsillectomy with or without epiglottopexy.

Objective

To assess the swallowing outcomes in children undergoing epiglottopexy with lingual tonsillectomy.

Methods

A retrospective case series review of children undergoing epiglottopexy with or without lingual tonsillectomy. All patients underwent an epiglottopexy with lingual tonsillectomy using coblation. A detailed evaluation including a sleep study, sleep endoscopy, and thorough swallowing assessment preoperatively as well as postoperatively was performed.

Results

Five children underwent epiglottopexy with lingual tonsillectomy for obstructive sleep apnea. Epiglottopexy improved sleep apnea with Apnea Hypopnea Index (AHI) falling significantly from 4.6 to 0.5 (p < 0.05). All patients had a normal swallowing assessment postoperatively with functional endoscopic evaluation of swallowing (FEES) revealing no evidence of aspiration and penetration.

Conclusion

In our case series epiglottopexy with lingual tonsillectomy is a safe and effective technique, which improves sleep apnea in pediatric patients. It does not affect the swallowing mechanism, and the epiglottis still retains the laryngeal protective role.

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References

  1. Marcus CL, Moore RH, Rosen CL et al (2013) A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med 368:2366–2376

    Article  CAS  Google Scholar 

  2. Bhattacharjee R, Kheirandish-Gozal L, Spruyt K et al (2010) Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study. Am J Respir Crit Care Med 182:676–683

    Article  Google Scholar 

  3. Friedman M, Wilson M, Lin HC, Chang HW (2009) Updated systematic review of tonsillectomy and adenoidectomy for treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 140:800–808

    Article  Google Scholar 

  4. Oomen K, Modi VK (2014) Epiglottopexy with and without lingual tonsillectomy. Laryngoscope 124:1019–1022

    Article  Google Scholar 

  5. Berry R, Brooks R, Gamaldo C et al (2013) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. Version 2.0.2. Darien, IL: American Academy of Sleep Medicine

  6. Bergeron M, de Alarcon A, Hart CK, Rutter MJ (2018) Factors associated with epiglottic petiole prolapse repositioning success. Laryngoscope

  7. Werner JA, Lippert BM, Dünne AA et al (2002) Epiglottopexy for the treatment of severe laryngomalacia. Eur Arch Otorhinolaryngol 259:459–464

    Article  CAS  Google Scholar 

  8. Whymark AD, Clement WA, Kubba H, Geddes NK (2006) Laser epiglottopexy for laryngomalacia: 10 years’ experience in the west of Scotland. Arch Otolaryngol Head Neck Surg 132:978–982

    Article  Google Scholar 

  9. Sandu K, Monnier P, Reinhard A, Gorostidi F (2015) Endoscopic epiglottopexy using Lichtenberger’s needle carrier to avoid breakdown of repair. Eur Arch Otorhinolaryngol 272:3385–3390

    Article  Google Scholar 

  10. Yellon RF (2006) Epiglottic and base-of-tongue prolapse in children: grading and management. Laryngoscope 116:194–200

    Article  Google Scholar 

  11. Ishman SL, Chang KW, Kennedy AA (2018) Techniques for evaluation and management of tongue-base obstruction in pediatric obstructive sleep apnea. Curr Opin Otolaryngol Head Neck Surg 26:409–416

    Article  Google Scholar 

  12. Logemann JA, Kahrilas PJ, Cheng J et al (1992) Closure mechanisms of laryngeal vestibule during swallow. Am J Physiol 262:338–344

    Google Scholar 

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Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Louisiana State University, New Orleans, LA, USA

    Sohit Paul Kanotra & Victoria B. Givens

  2. Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, 21266 PFP, Iowa City, IA, 52242, USA

    Sohit Paul Kanotra

  3. Department of Pediatric Gastroenterology, Children’s Hospital New Orleans, New Orleans, LA, USA

    Brent Keith

Authors
  1. Sohit Paul Kanotra
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  2. Victoria B. Givens
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  3. Brent Keith
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Correspondence to Sohit Paul Kanotra.

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Kanotra, S.P., Givens, V.B. & Keith, B. Swallowing outcomes after pediatric epiglottopexy. Eur Arch Otorhinolaryngol 277, 285–291 (2020). https://doi.org/10.1007/s00405-019-05664-6

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  • DOI: https://doi.org/10.1007/s00405-019-05664-6

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